As we age, so do our knees. For some of us, they crack and snap and pop and grind. They hurt and swell and give out. They are affected by the weather and how much we decide to do in a day. Sometimes, you may feel one moment that causes the downward spiral, whereas other times it sneaks up on you as time goes on. However your symptoms begin, Orthopaedic Associates of Wisconsin is here to help you age as gracefully as possible.
We will start with x-rays of the knee to assess the joint because bony integrity ultimately affects how care proceeds. Even if one of our older patients presents with symptoms that sound like the result of a meniscus tear, an arthritic knee identified on x-ray renders a knee arthroscopy ill-advised often times. Cleaning up the meniscus tear (a procedure called a menisectomy) in an arthritic knee will often provide temporary relief, if any. The rough edges of bone will continue to tear and damage the meniscus, and the risks of surgery will have all been for naught.
If the symptoms caused by an arthritic knee are aggravating enough to affect daily activity and quality of life, the appropriate procedure would be a total knee arthroplasty, more commonly known as a total knee replacement. The arthritic portions of the tibia and femur are removed along with the meniscus; thus nullifying any degenerative tears that exist. Then the prostheses that will provide smooth surfaces for normal joint function are inserted. After several months of extensive physical therapy, your new artificial knee will begin to function similarly to the original.
On the other hand, if those x-rays of the bothersome knee show little to no arthritis or degenerative changes, an MRI will likely be ordered to determine the location and extent of a potential meniscus tear. When such characteristics have been determined, conservative versus surgical management can be determined. Some meniscus tears can be treated with a cortisone injection to calm down inflammation as well as physical therapy to help the surrounding musculature continue to support the knee appropriately. Other meniscus tears are in locations that are particularly bothersome to patients and surgical intervention is warranted to trim out the aggravating tear to restore pain free function. In rare cases, a bucket-handle meniscus tear can cause the torn fragment to become lodged in the joint and cause the knee to lock. Such meniscus tears are treated surgically and in a more expedient fashion to regain knee function and mobility.
Depending on the extent of degenerative changes present in a knee that is also found to have a meniscus tear, the treatment plan could be a little foggy. Our board-certified physicians will map out different treatment plans available to you, which sometimes involve some trial and error. It can be a challenge to determine if a patient’s symptoms are being caused by the meniscus tear or arthritis. Sometimes a cortisone injection can be helpful in determining the root cause of the discomfort due to how the knee reacts to the injection. If swelling, inflammation, and pain decrease significantly after a cortisone injection, the likely culprit was arthritis. If symptoms persist, the meniscus tear may need to be addressed with some physical therapy, arthroscopic surgery, or both. Regardless of what type of knee pain brings you limping through our doors, let Orthopaedic Associates of Wisconsin help you find the treatment that gets you running back out again.
This blog is written by one of our very own-Morgan. She is a certified athletic trainer working as a medical assistant with our providers each and every day in our clinic. She obtained a bachelor's degree in athletic training from Carroll University in Waukesha and a master's degree in Kinesiology from Michigan State University. She is excited to bring you updates and information about the happenings at OAW.